More than a job: Facing difficult realities in northern Canada

Stephanie Minorgan

I still clearly remember one of my first visits as a family physician to a small Native* community in northern Canada. I feel fortunate to have experienced the untouched beauty of the North. The sunset over Hudson Bay takes your breath away, and the northern lights that dance in the night sky are more awe-inspiring than anything you could ever imagine.

Sometimes we family doctors forget what a privilege it is to glimpse the most private moments in the lives of our patients. During my stay in the North, witnessing the intimate details of people’s lives connected me to the community in a unique way—a different experience than I would have had simply visiting the region. Very quickly, I saw how people from the North face difficult realities, and facing them myself was challenging.

Suicide of a young girl

An elder came to see me on my last day in the community, and I cannot get his story out of my mind. He had just come back from 3 months in “the bush,” where people return to the land to live a more traditional life. While he was there, he heard that a very young girl had killed herself in the community. This troubled him greatly. He had difficulty sleeping, he could barely eat anything, and after several weeks, he could no longer even hunt or fish—which he needed to do to survive. He was preoccupied and wondered, “What kind of future do we have as a people when our children are killing themselves?” He returned from the bush early to see his grandchildren before they too (he feared) took their own lives in acts of desperation.

The overwhelming sadness this elder felt for the young people in his community touched me deeply. I could not grasp why such a young girl—barely a teenager—would take her own life. That was the moment I realized that, even though I saw the challenges that people face every day in the North, I did not understand them. The experience of illness is partly culturally defined; without meaningful knowledge of the culture of the people in this community, it was difficult to appreciate their experience of illness.

Commitment to knowledge

On the long journey south, I made a commitment to learn more about the culture of the Native people in northern Canada, with the goal of being more patient-centred during my next visit. Shortly afterward, I happened upon an incredible book by Naomi Adelson entitled Being Alive Well. Health and the Politics of Cree Well-Being. This book has helped me understand my role as a health care provider in northern Canada, and from it I learned more about Native culture than I ever did in medical school. Although most Canadian medical schools try to prepare physicians to be sensitive to the multicultural needs of Canadians, little of this preparation focuses on the unique needs of First Nations Canadians. As a teacher, I plan to spend more time talking with medical students and residents about working in the North, and I will encourage them to read Adelson’s book, among others. I hope that this will better prepare them to work with all First Nations Canadians when they are finished their training.

I look forward to my next trip to the North. It is a beautiful place with beautiful people, and working there captures the essence of what it is to be a family doctor: you are constantly learning—not only about clinical medicine, but about people and about yourself.

For further reading

Adelson N. Being Alive Well. Health and the Politics of Cree Well-Being. Toronto, Ont: University of Toronto Press; 2000.